Updating advances and controversies on the multidisciplinary therapy of gastric cancer

Gastric cancer is one of the most common malignancies. In recent years, the overall treatment modality of gastric cancer has been an integrated mode that combines standardized surgery and perioperative adjuvant therapies based on anatomy, tumor biology and immunology. Reasonable staging of gastric cancer is of great significance in guiding the choice of integrated treatment programs, determination of the efficacy and prognosis. Despite more detailed and accurate staging for gastric cancer and prognosis identification in the updated staging system, more are left to be solved. At the same time, the role of free intraperitoneal cytology and laparoscopy in staging should also be given adequate attention. In terms of operations, after years of extensive debate and exploration, D2 lymph node dissection involving nodes around named branches of the celiac trunk has been considered as a standard treatment. While the development of perioperative adjuvant treatment has substantially improved the outcomes of advanced gastric cancer, altered treatment strategies have also brought new challenges. In recent years, the rapidly developed new treatment technologies and targeted therapy combined with traditional chemotherapy provide a new opportunity for breaking through the existing bottleneck in this field.